Can an the insurance company legally terminate my daughter’s care, if numerous doctors and therapisst have deemed further treatment medically necessary?

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Can an the insurance company legally terminate my daughter’s care, if numerous doctors and therapisst have deemed further treatment medically necessary?

I have a child with cerebral palsy. She has been covered for therapy by my union insurance company since the age of 2. Her life time coverage for medical is $1,000,000. She has recently been denied further coverage for therapy. She is 7 and may require additional surgery and therapy.

Asked on June 2, 2012 under Insurance Law, Georgia

Answers:

M.T.G., Member, New York Bar / FreeAdvice Contributing Attorney

Answered 9 years ago | Contributor

There are many "little" issues here that you need to discuss with ana ttorney that can read through the policy dicuments to determine what you need to do. Why are they refusing treatment?  Is it because she has reached the million dollar mark?  There are isues with pre existing conditions and the law has changed as to same and the your rights and the responsibilities of the insurance company.  You may have to sue them and ask the court for a declaratory judgement on the issue.  Good luck.


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